Abstract P001: Greater Time Spent in Ideal Cardiovascular Health in Adulthood is Associated With Lower Risk of Cardiometabolic Outcomes and Death: the Framingham Heart Study

Abstract

Introduction: The AHA ideal cardiovascular health (CVH) metric evaluated on a single occasion is associated with risk of cardiovascular disease (CVD). It is unclear if greater time spent in ideal CVH during midlife influences morbidity and mortality. Hypothesis: We hypothesized that maintenance of ideal CVH for a longer duration in midlife is associated with lower risk of hypertension, diabetes mellitus, chronic kidney disease (CKD), atrial fibrillation, CVD, CVD sub-types (coronary heart disease, stroke, congestive heart failure, and peripheral artery disease), and all-cause mortality. Methods: We evaluated 2609 Framingham Offspring Study participants (mean age 61 years; 54% women) who attended examination cycle 7 [1998-2001]. CVH scores were calculated using smoking status, diet, physical activity, total serum cholesterol, resting blood pressure, body mass index, and fasting blood glucose for a total score of 0-14 (score of 0-7 = poor; 8-11 = intermediate; 12-14 = ideal). We determined time spent in each CVH score category during midlife (using data from examination cycles 5 [1991-1995] through 7 (6426 person-exams). Incident hypertension, diabetes, and CKD were assessed at sequential follow-up examinations whereas incident atrial fibrillation, CVD, CVD sub-types, and mortality were assessed based on continuous surveillance through 2015. Years spent in a given CVH score category were related to each outcome using proportional hazards regression with discrete (for hypertension, diabetes, and CKD) or continuous (other outcomes) time, adjusted for age, sex, and baseline values (e.g., fasting blood glucose for diabetes). Results: At examination 7, participants mostly had poor (40%) or intermediate (54%) CVH scores. For each 5-year duration that participants had poor CVH, they were more likely to develop adverse outcomes (Figure). Conclusions: Maintenance of ideal CVH for a longer duration in midlife may have salutary cardiometabolic benefits and be associated with a lower risk of all-cause mortality.